BY BRIGHT JACOB
The President of the National Association of Nigeria Nurses and Midwives, Abdulrafiu Adeniji, has disclosed that the association is helpless and cannot do anything to stop the mass exodus of Nigerian nurses seeking greener pastures in developed countries because of the condition of service in Nigeria and job satisfaction.
The Secretary-General/Registrar of the Nursing and Midwifery Council of Nigeria, Faruk Abubakar, had announced in Delta State that over 7,000 professional nurses leave the country annually for greener pastures. According to him, it was an indication that Nigerian nurses were well equipped, competent and hardworking.
In an interview with The Point, Adeniji called upon the government to begin to invest more on the training of nurses in the country, and also ensure that the nurse-to- patient-ratio, in various hospitals across the country, be adequately addressed.
“I will not say that the exodus of our nurses just started, but it’s just that this time around, it is more. When you look at the nature of the exodus in the past, it was just a few nurses that were involved, but now, they’re in multitudes.
“In all these, our position is that anyone moving out of this country should not suffer. We cannot stop them from goingl
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“In all these, our position is that anyone moving out of this country should not suffer. We cannot stop them from going. What we do is that we collaborate with other bodies like the Charitable Nurses Organisation in the United Kingdom, the National Association of Nurses and Midwives in North America, the International Association of Psychiatric Nurses in Nigeria and the Chinese Nurses Association to ensure that whenever our nurses get to their destinations, there will not be any form of enslaved labour, and their welfare is also taken care of. In fact, we have signed a memorandum of understanding with most of these bodies,” he said.
Adeniji also said that the damage control the association does is to dialogue with the federal government to make provisions so that after nurses have gone and acquired more skills abroad, they can be brought back to the country in some capacity to serve.
“For instance, there was a programme the federal government attempted in the past, where nurses were invited into the country for at least one or two months to share their wealth of experience,” he stated.
Though the government had on various occasions decried the level of nurses’ migration and its short and long term effects on the health care delivery system in the country, Adeniji said that the government has also contributed to the mass exodus, and should therefore do more to salvage the situation.
He also wondered why the government can leave nurses’ education to parents alone, saying, “The government has a policy (referring to teachers) where they said that anyone whose training was financed by them would spend a certain number of years in their states of origin working, before going to work somewhere else. Unfortunately, health care professionals in Nigeria used their money for their training; and except for medical doctors during their residency, all others used their parent’s money to finance their education, and so when they are out of school, they have the right to select where they would want to work.”
According to the World Health Organisation, the recommended nurse-to-patient-ratio should be 1 to 600, that is, one nurse to about 600 patients.
However, according to Shakuri Kadiri, deputy director and head of human resources for health, in the federal ministry of health, Abuja, as at March 2020, the nurse-to- patient-ratio in Nigeria was 1 to 1,135, or better still, 88 nurses per 100,000 patients, and this figure is expected to increase in 2021.
Deducing reasons for this, Adeniji said, “in Nigeria today, with a population of more than 200 million, we ought to have about 800, 00 nurses working in this country, as recommended by the WHO, but we just have less than 200,000 nurses, and this figure includes, not just nurses in the public sector, but also nurses in the private sector, and those who are self-employed.”
Adeniji added that an ageing workforce in the cadre of professional nurses was also responsible for the low nurse to patient ratio.
He said that this posed a serious danger to Nigeria’s health care delivery system, and he enjoined the government to lift the embargo on the employment of health care professionals.
He pointed out that if the government wasn’t employing, it should at least make the retirement age of nurses to be 65 so that “we don’t lose all the experienced ones at once.”
Factors responsible for the migration, according to Adeniji, include the ability of Nigerian nurses to work anywhere in the world owing to the level of training they got in Nigeria, environmental factors, economic reasons, condition of service and because of the impact of COVID-19.
“Nigerian nurses are trained to be proficient. That is why developed countries prefer to recruit us, and we usually meet with other nurses from other parts of the globe, who attest to the performance of Nigerian nurses. This is why I always say that we must look at the environment nurses practice in Nigeria to be able to address the brain drain in the health sector,” he noted.
Shedding more light on the brain drain, Adeniji said that it is not only taking place among those who intend to move from Nigeria to overseas, but that there’s also brain drain among those working in the local government areas who want to move to teaching hospitals, and the ones in the private sector who want to move to the public sector.
“The truth is that we are bleeding out and there’s no infusion of blood into our system. Everything is wasting and we are being constrained.
“The condition of service for nurses in Nigeria is nothing to write home about. For instance, there are no scholarship programmes by the government for nurses.” He went further to state that any nurse who eventually completed his or her training would definitely want to be gainfully employed and that for economic reasons, they would travel out when their salaries do not commensurate with the services they render.
Adeniji also observed that job satisfaction, which had nothing to do with “naira and Kobo”, but which has a lot to do with the environmental factor, was not available and that often, the environment doesn’t permit them to demonstrate their know-how, and this creates “some sort of uncomfortable conditions for them.” He added that those who couldn’t practice here are those who eventually did well outside the shores of the country. “When situations that make people unable to perform well change outside the country, you will see our nurses excelling,” he said.
On the impact of COVID-19 contributing to nurses’ migration, Adeniji said that while Nigeria was sleeping, other countries made preparations for the future and ensured that they recruited and took care of their health care system to combat or reduce the impact of the disease.
“For those of us in Nigeria, there are nurses roaming the streets, there are some who are underemployed, and as a result, the situation is so bad.”
He pointed out that while other countries were engaging their nurses, Nigeria was allowing hers to be taken away.
